Expert Panel Recommendations on Lower Urinary Tract Health of Women Across Their Life Span

Losada, Liliana; Amundsen, Cindy L.; Ashton‐Miller, James A.; Chai, Toby C.; Close, Clare E.; Damaser, Margot S.; DiSanto, Michael E.; Dmochowski, Roger R.; Fraser, Matthew O.; Kielb, Stephanie; Kuchel, George A.; Parker-Autry, Candace; Wolfe, Alan J.; Mallampalli, Monica P.

doi:10.1089/jwh.2016.5895

Cited by 15 publications

(6 citation statements)

References 99 publications

(99 reference statements)

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“…The foci of current research on LUT sex differences are anatomical and physiological differences, while little attention has been paid to sex differences at the cellular level of the LUT. Further investigation of sex differences in LUT cell types is needed to better develop our understanding of normal and abnormal LUT function [ 3 ]. Elucidation of these differences in the LUT is essential to providing optimal treatment for urinary dysfunction in both women and men.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in lower urinary tract biology and physiology

Abelson

Sun

Que³

et al. 2018

Biol Sex Differ

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Females and males differ significantly in gross anatomy and physiology of the lower urinary tract, and these differences are commonly discussed in the medical and scientific literature. However, less attention is dedicated to investigating the varied development, function, and biology between females and males on a cellular level. Recognizing that cell biology is not uniform, especially in the lower urinary tract of females and males, is crucial for providing context and relevance for diverse fields of biomedical investigation. This review serves to characterize the current understanding of biological sex differences between female and male lower urinary tracts, while identifying areas for future research. First, the differences in overall cell populations are discussed in the detrusor smooth muscle, urothelium, and trigone. Second, the urethra is discussed, including anatomic discussions of the female and male urethra followed by discussions of cellular differences in the urothelial and muscular layers. The pelvic floor is then reviewed, followed by an examination of the sex differences in hormonal regulation, the urinary tract microbiome, and the reticuloendothelial system. Understanding the complex and dynamic development, anatomy, and physiology of the lower urinary tract should be contextualized by the sex differences described in this review.

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Section: Introductionmentioning

confidence: 99%

Sex differences in lower urinary tract biology and physiology

Abelson

Sun

Que³

et al. 2018

Biol Sex Differ

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“…In clinical practice, non-surgical therapies are the first line of treatment, including behavioral therapy with strategies for re-education of the bladder, training of pelvic muscle tone, biofeedback, electrical stimulation, vaginal cones, control of intake of caffeine, and pharmacological treatment, varying according to each case or type of urinary incontinence. [5,7,8] Due to numerous options of treatments, many professional organizations have developed guidelines to help clinicians treat patients with urinary incontinence [7] …”

Section: Introductionmentioning

confidence: 99%

Critical appraisal of clinical practice guidelines for treatment of urinary incontinence

Smiles

Mazzei²,

Lopes³

et al. 2019

Medicine

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Background:Urinary incontinence is a common complaint in all parts of the world, cause of distress, as well as significant costs for both individuals and society. The aim of this study will be to evaluate the rigor of the development of clinical practice guidelines and to identify the recommendations of interventions for urinary incontinence in adult women.Methods:In this systematic review, clinical practice guidelines will be identified using a prospective protocol through a systematic search of: MEDLINE (via Ovid); EMBASE (Excerpt Medical Database, via Ovid); Web of Science and Virtual Health Library. Specific databases of guidelines for clinical practice will also be searched (National Institute for Health and Care Excellence, American Urological Association, and others). Reviewers, independently and in duplicate, will assess the quality of the guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE II). The results will be checked for discrepancies. Differences between the scores equal to or greater than 2 will be considered as discrepant and the final result will be decided by consensus. A comparison of the recommendations of interventions and information about the level of evidence, the degree of recommendation, the level of agreement and the level of acceptance will be described. This step will also be done independently and in duplicate, and the result will be decided by consensus. The results will be presented in tables and the descriptive statistics will be calculated for all domains of the AGREE II instrument as mean (standard deviation) and median (interquartile range).Results:The results derived from this study will increase the knowledge about the development of recommendations guidelines for urinary incontinence of high methodological rigor. This study may also identify key areas for future research.Conclusion:This study may guide health professionals, policy makers, and health policy managers in choosing the guidelines for recommendation in clinical practice.Protocol Registration:PROSPERO - CRD42018116517

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“…Taking into account that among the risk factors for the development of urinary incontinence in women an important place have heredity [11,28], metabolic syndrome and overweight [24,26], age [9] it is quite understandable to study the possibility of OAB in pregnant women of different age groups depending on the characteristics of anthroposomatotypological indicators or hormonal background. W hen taken into account anthropometric and somatotypological indicators it was established that in women of different age groups, the discriminant model of the possibility of OAB occurrence covers 86.7% of pregnant women aged from 17 to 25 years, 90.9% of pregnant women aged from 26 to 35, and 89.3% of pregnant women aged from 36 to 41 years.…”

Section: Discussionmentioning

confidence: 99%

Modeling the possibility of occurrence of overactive bladder in women of different ages, depending on anthropo-somatotypological indicators or hormonal background with the help of discriminant analysis

Kostyuk

Chayka

Storozhuk

et al. 2019

Biomed. and Biosoc. Anthrop.

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One of the most important problems of modern urogynecology is the improvement of the treatment-diagnostic algorithm and prevention of overactive bladder syndrome (OAB). The purpose of the work is to construct and analyze discriminant models of the possibility of OAB occurrence in pregnant women of different age groups depending on the characteristics of anthropo-somatotypological indicators or hormonal background. 75 pregnant women with clinical signs of OAB syndrome and 60 healthy pregnant women had hormonal screening in the 1st and 3rd trimester of pregnancy and at 16 weeks postpartum using radioimmunoassay and immune enzyme methods (estradiol, progesterone, thyroid stimulating hormone and testosterone levels were determined). The anthropometry was carried out according to the method of V. V. Bunak, the components of the somatotype were determined according to the method of J. Carter and B. Heath, as well as the components of the body composition according to the method of J. Matiegka and the American Institute of Nutrition (AIN). By age, all pregnant women were divided into 3 subgroups: І - from 17 to 25 years, ІІ - from 26 to 35 years, ІІІ - from 36 to 41 years. A discriminant analysis of the possibility of OAB occurrence, depending on the anthropo-somatotypological or hormonal indices in women of different age groups, was conducted using the licensing program “Statistica 5.5”. When taken into account anthropo-somatotypological indices in women aged from 17 to 25 years, the model is correct in 86.7% of cases; in women aged from 26 to 35 years - in 90.9% of cases; in women between the ages of 36 and 41 years - in 89.3% of cases. Between healthy and OAB patients, women aged from 17 to 25 years discriminating variables are the width of the distal epiphysis of the shoulder (which has the greatest contribution to discrimination), conjugata externa, the muscle component of the body weight by AIN and the forearm's girth in the upper third; women from 26 to 35 years - dist. Іntеrtrochantericа, the width of the distal epiphyses of the forearm (the greatest contribution to discrimination), hip circumference, conjugata externa, mesomorphic component of the somatotype according to by Heath-Carter, fat mass component of the body by Matiegka, the forearm's girth in the upper third and the shoulder girth; women of age from 36 to 41 years - the width of the distal epiphysis of the leg (which has the greatest contribution to discrimination) and the length of the body. In general, the aggregate of all variables has a low level of discrimination between healthy and sick with OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.531; F = 5.521; p <0.01) and 36-41 years (Wilkes Lambda statistics = 0.445; F = 15.62; p <0.001), while among women between the ages of 26 and 35 - the average level of discrimination (Wilkes Lambda statistics = 0.386; F = 13.52; p <0.001). When taken into account characteristics of the hormonal background in women of all ages, the model is correct in 100% of cases. Between healthy and OAB patients, of 17-25 years age, discriminant variables are estradiol levels at 16 weeks of postpartum (with the largest contribution to discrimination) and prolactin levels in the first trimester of pregnancy; women aged from 26 to 35 years - estradiol levels at 16 weeks of postpartum (the most contributing to discrimination), testosterone in the third trimester of pregnancy, estradiol in the third trimester of pregnancy, prolactin in the third trimester of pregnancy, estradiol in the first trimester of pregnancy, and testosterone levels in the first trimester of pregnancy; women aged from 36 to 41 years - estradiol in the third trimester of pregnancy (has the largest contribution to discrimination) and estradiol in the 16 weeks of postpartum period. In general, the totality of all variables has a low level of discrimination between healthy and sick at OAB women between the ages of 17 and 25 (Wilkes Lambda statistics = 0.619; F = 131.4; p <0.001) and ages 26-35 (Wilks Lambda statistics = 0.493; F = 224.9; p <0.001), while among women between the ages of 36 and 41 - the average level of discrimination (Wilkes Lambda statistics = 0.371; F = 207.4; p <0.001). Thus, with the aid of discriminant analysis, reliable models of the possibility of OAB occurrence, based on anthropo-somatotypological or hormonal indices in women of different age groups, are constructed. In all age groups, the greatest contribution to discrimination between healthy and sick with OAB pregnant women, in most cases, make parameters of the width of distal epiphyses of long limb bones or the level of estradiol.

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Expert Panel Recommendations on Lower Urinary Tract Health of Women Across Their Life Span

Cited by 15 publications

References 99 publications

Sex differences in lower urinary tract biology and physiology

Sex differences in lower urinary tract biology and physiology

Critical appraisal of clinical practice guidelines for treatment of urinary incontinence

Modeling the possibility of occurrence of overactive bladder in women of different ages, depending on anthropo-somatotypological indicators or hormonal background with the help of discriminant analysis

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